Your Child’s Sick: Is It Asthma or a Cold?

Your child is coughing and sniffling. Is it a cold or virus? Let’s look at the differences to help you soothe your child and know when it’s time to see a doctor.

In children, both asthma and colds can cause difficulty breathing, wheezing and coughing. Colds, which usually resolve in a week or so, also typically include a runny or stuffy nose, sore throat, headache and fever.

But there are symptoms that might indicate your child has asthma:

• Chest tightness
• Burning in chest
• A feeling of not being able to take a full breath

Other clues: Asthma symptoms often are worse at night and have triggers like environmental allergens, exercise and cold air.

To help determine if your child has a cold or asthma, keep a symptom log that documents the time and duration of your child’s symptoms. You can take that and video recordings to your pediatrician. If your child must frequently go to urgent care or an emergency room for coughing or wheezing, ask to consult with a pediatric pulmonologist.

How Asthma and Colds Develop

A cold develops when a virus enters and infiltrates the body through the respiratory tract, causing an immune system response that generates inflammation and mucus production one to three days after your child is exposed to the virus. Viral infections, such as rhinoviruses and coronaviruses, are spread through respiratory droplets and contaminated surfaces. Many infants who get viral colds or bronchiolitis will wheeze during and shortly after infection but do not develop asthma.

Asthma typically develops gradually as a chronic condition, which can be caused by your child’s exposure to things in the environment like allergens, pollution and other airborne irritants. It also has a strong genetic link, so parents who have (or had) asthma should be vigilant in looking for signs and symptoms of asthma. Many children “outgrow” asthma to some extent as they get older, meaning they do not require asthma treatments for life.

Importantly, viral infections can trigger asthma attacks. Unlike colds, which resolve after the acute infection clears, your child’s asthma can come and go with exposure to triggers. This means your child actually could experience a cold and an asthma attack at the same time.

Don’t Wait To See the Doctor

Having your child seen by a medical provider when you suspect a cold can help with early detection of more serious illnesses like flu, RSV and COVID-19 and potentially head off complications like ear infections.

Early diagnosis of asthma is important for several reasons. Children with asthma tend to feel much better after starting treatments with inhaled medications that target excess inflammation in the airways. Treating asthma earlier in life also prevents long-term changes to the structure of the lungs that is known as “airway remodeling.” This means the cells lining the respiratory tract can become abnormally thick and hypersensitive to airborne irritants, and fibrosis and scarring of the airways can occur.

Differences in Treatments

Colds usually are managed with supportive care because cold viruses don’t respond to antibiotics. Symptoms typically go away after seven to 10 days. You can help your child by:

• Ensuring adequate hydration
• Using saline nasal drops or spray to relieve congestion
• Gentle suctioning for infants who can’t blow their noses
• Giving age-appropriate fever reducers like acetaminophen or ibuprofen

You should not give honey to infants younger than 1 year with a cough or cold. Over-the-counter cold medications are not recommended in children younger than 6 because of potential side effects and little benefit. Doctors generally discourage cough suppressants — especially if there is the possibility of asthma — because these medications can mask symptoms.

Asthma is treated with inhaled medications that target the excessive inflammation in cells that line airways in the respiratory tract. Some of these medications are called bronchodilators because they help open up constricted airways. Other medicines include inhaled low-dose corticosteroids to reduce inflammation. There also are monoclonal antibody treatments for severe or resistant cases, that are FDA approved for asthma in children 6 years and older.

You should seek medical help from your child’s pediatrician or a specialist in pulmonary diseases whenever you are concerned that your child’s cough or breathing goes beyond a simple cold. You also may notice your child coughing more than other kids or having trouble keeping up with activities because they become short of breath. A visit to the doctor can help ease your mind and your child’s condition.

This content is not AI generated.